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Cardiovascular Research 2000 45(4):843-852; doi:10.1016/S0008-6363(99)00377-6
© 2000 by European Society of Cardiology
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Copyright © 2000, European Society of Cardiology

Arterial remodeling in atherosclerosis, restenosis and after alteration of blood flow: potential mechanisms and clinical implications

Gerard Pasterkampa,*, Dominique P.V de Kleijna and Cornelius Borstb

aInteruniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
bExperimental Cardiology Laboratory, Utrecht University Medical Center, Utrecht, The Netherlands

* Corresponding author. Correspondence address: Heart Lung Institute, Utrecht University Hospital, Heidelberglaan 100, Room G02.523, 3584 CX Utrecht, The Netherlands. Tel.: +31-30-250-7155; fax: +31-30-252-2693 g.pasterkamp{at}hli.azu.nl

Arterial remodeling is currently being recognized as an important determinant in vascular pathology in which narrowing of the lumen is the predominant feature. Not only expansive remodeling (enlargement), but also constrictive remodeling (shrinkage) is observed in de novo atherosclerosis, in restenosis and in transplant vasculopathy. Expansive remodeling prevents and constrictive remodeling enhances luminal narrowing by plaque formation or intimal hyperplasia. The mechanisms of the opposite remodeling modes is unknown. Insight into the processes that determine the direction of local arterial remodeling may help to develop new strategies to prevent arterial occlusive disease. In the present paper the current status of research in the field of arterial remodeling in cardiovascular disease is reviewed. Mechanisms of arterial remodeling, potential interventions to influence the mode of remodeling as well as the methodological limitations of remodeling studies are discussed.

KEYWORDS Angioplasty; Arteries; Artherosclerosis; Blood flow; Remodeling; Restenosis


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